| Objective: To explore the value of parameters obtained by DWI,IVIM and DKI,the value of which can better differentiate malignant from benign breast lesions with plateau time-signal-curve（TIC type-II）in DCE-MRI.Methods:A total of 103 patients with breast TIC type-II lesions in Jining Medical College Hospital from October 2019 to January 2021 were reviewed retrospectively.The patients were divided into benign group（25 patients,25 lesions）and malignant group（78 patients,78lesions）according to the pathological results,the ADC value,true diffusion coefficient（D value）,perfusion-related diffusion coefficient（D*value）,perfusion fraction（f value）,mean diffusion rate（MD value）and mean kurtosis value（MK value）were measured.Independent samples t-test was used to compare the differences of each parameter between two groups,and univariate/multivariate logistic regression analyses were further performed.Receiver operating characteristic curve（ROC）and area under the curve（AUC）were used to analyze the efficacy of each parameter alone or in combination diffusion models（DWI+IVIM,DWI+DKI and DWI+IVIM+DKI）in the differential diagnosis of breast TIC type-II benign and malignant lesions.Results: The values of the two groups including ADC,D,F,MD,and MK were significantly different（P < 0.05）.Multiple logistic regression analysis showed that the D value and MK value were independent influencing factors in the differential diagnosis of the two groups,with the largest odds ratio for MK value（AUC 0.871,specificity88.0%,and sensitivity 80.8%）.Each combined two diffusion models had not no significant difference using ROC analysis.（P > 0.05）,but three-model combination achieved the greatest diagnostic efficiency（AUC 0.915,sensitivity 92.3%,and specificity 84.0%,）which was statistically higher than that of DWI（AUC 0.816,P<0.05）.Conclusion: DWI combined with IVIM and DKI have a good differential diagnostic value for benign and malignant breast TIC type-II lesions. |
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